HHS on ACOs: Center for Medicare and Medicaid Innovation

 | No Comments on HHS on ACOs: Center for Medicare and Medicaid Innovation

The following is a piece of an upcoming review we will be releasing  on Accountable Care Organizations (ACOs).  It deserves a expidited mention in that it is slightly overdue…

The HHS is also taking cues from industry thought leadership.  The CMS is moving to take an additional and different approach to solving some of the quandaries currently extant in Healthcare. The most recent step in CMS’ involvement in reform is the establishment of The Center for Medicare and Medicaid Innovations (CMMI).  This specific organization will be undertaking research and workgroups focused on “patient outcomes” and “community care models.” They are even taking public comments at the moment.  This center will perpetuate new efforts toward the development of ACOs in addition to finding ways to approach Medicaid and Medicare from new directions and analysis.  There is an expressed interest in the speed and pace of the solutions development as an underlying layer of the CMMI strategy.

Introducing the CMS Center for Medicare & Medicaid Innovation – and innovations.cms.gov

 | No Comments on Introducing the CMS Center for Medicare & Medicaid Innovation – and innovations.cms.gov


By Don Berwick, M.D., Administrator of the Centers for Medicare & Medicaid Services

We have been given a great opportunity – under the historic Affordable Care Act – to create the Center for Medicare and Medicaid Innovation. Continue reading: Introducing the CMS Center for Medicare & Medicaid Innovation – and innovations.cms.gov

AMA Establishes New Principles for Accountable Care Organizations

 | 1 Comment on AMA Establishes New Principles for Accountable Care Organizations

RE-POST FROM: http://www.ama-assn.org

CHICAGO – New principles for the development and operation of Accountable Care Organizations (ACOs) became American Medical Association (AMA) policy this week at the organization’s semi-annual policy-making meeting. ACOs are an emerging model of patient care designed to provide high-quality patient care in an efficient manner.

The AMA’s new principles emphasize that ACOs must be physician-led, place patients’ interest first, ensure voluntary physician and patient participation and enable independent physicians to participate.

“The AMA is committed to ensuring physicians in all practice sizes can lead and participate successfully in new models that allow them to provide the best care to their patients,” Dr. Wilson said. “For this to happen, significant barriers must be addressed, including a lack of resources, existing antitrust rules and conflicting federal policies.”

During a recent joint government agency meeting, AMA President Cecil B. Wilson, MD. testified that there should be enough flexibility for physicians in all practice sizes to participate in ACOs. Although ACOs and other models of patient care were recently authorized in the new health reform law, existing antitrust and fraud rules can make becoming part of an ACO difficult for physicians, especially those in small practices. According to the latest AMA Physician Practice survey, 78 percent of office-based physicians in the United States work in practices with nine physicians or less. A majority of those are in either solo practices or practices of 2 to 4 physicians.

The AMA is developing resources for physicians to help them make informed participation decisions about ACOs. Physicians can find the tools they need to successfully participate and lead new initiatives, like accountable care organizations, on the AMA Web site at: www.ama-assn.org/go/paymentpathways.